With the advancement of technology now complex congenital heart diseases can be diagnosed antenatally even before the baby is fully developed between 16- 20 weeks of pregnancy. According to diagnosis and prognostic significance, parents are counseled so that they can be prepared for forthcoming events and decide accordingly. and with preparedness perinatal, neonatal and infant mortality rates can be brought down.
INDICATION OF FETAL ECHO-
First-degree relative of the proband (mother or father) with CHD
A prior child with CHD born to mother and/or father
Pre-existing metabolic disease Type 1 diabetes, Phenylketonuria
Infections Parvovirus B19 Rubella, Coxsackie
Autoimmune antibodies Anti-Ro (SSA) Anti-La (SSB)
Teratogen exposure Retinoids, Phenytoin, Carbamazepine, Lithium carbonate, Valproic acid, Paroxetine
Increased nuchal translucency thickness
Abnormal ductus venosus waveform
The abnormal fetal cardiac screening exam
Major extracardiac abnormality
Abnormal fetal karyotype
Fetal cardiac dysrhythmias
Persistent bradycardia or tachycardia
Recently we had few patients -
1. We diagnosed the Transposition of great arteries at 17 weeks of gestation by Fetal echocardiography in a young, ambitious mother. it is a complex CHD that require early surgery in neonatal period within a few days of birth with a highly skilled surgeon. we explained to them in detail about prognosis, possible options and precautions to be taken.
2. A 29 weeks gestation mother referred to us due to some mass suspected in the thorax, we examined fetus's thorax and heart thoroughly and diagnosed to have multiple huge rhabdomyoma of heart-filling whole RV cavity wit two others in LV cavity, associated heart failure of the baby. we explained the risk to baby, prognosis and available treatment and options.
We have well developed fetal medicine centre with separate, advanced, state of the art machine for fetal examination With experienced operators Dr. Prashant Agrawal (Pediatric and Fetal cardiologist) and Dr. Praveen Agrawal (Fetal Sonologist). Fetal Echo is followed by counseling sessions of parents which help them to understand the nature and prognosis of a fetal anomaly if detected, their postnatal implications and available options.